Can someone please explain why we don't have apneas awake?

[Moogy]

I have been wondering why don't we have apneas while we are awake? Does the waking brain pay more attention to the breathing? It is NOT just the position we sleep in, right? Because most of us still have apneas if we try to sleep sitting up...

Can someone please explain? Thanks, Moogy

[Linda3032]

I would guess that our neck and throat muscles are able to keep our airways open when we're awake. But when we sleep, all of our muscles relax.

[dvejr]

Great question, and I believe that I DO. Very rarely I find myself gasping for a breath after I appear to have forgotten to inhale on schedule.

[Guest]

You do/can have apnea events while you are awake.

Apnea means to stop breathing!

If you hold your breath you cause yourself to have an apnea.

For an example of an "Obstructive Awake Apnea" (OAA?) you could have someone grab your neck with both hands and squeeze.

[snoozalot]

ozij posted this link elsewhere in the forum. It gives a great explanation. It takes a very long time to load, so be patient. Also, turn up your sound.

Bob

http://resmed.com/Shared/StaticFiles/-n ... 40x380.swf

[Moogy]

Snoozalot, thanks for posting the link to that movie on sleep apnea. It has great visuals that make it easy to understand the mechanism in sleep apnea.

Moogy

[yardbird]

I can have an apnea event while awake. Maybe not a full blown apnea, but restricted airway followed by a gasp. Several years ago I was in a car accident and sufferred a compression fracture in my neck. A couple of years after that they fused it. During the time it took them to figure out what to do I sufferred enough nerve damage to cause muscles in my neck and shoulder to atrophe. When I meditate I relax. When I relax my head can drop forward. This can happen when I'm lying down (not the head forward part... just the relaxation part) as well. Sometimes people think I fell asleep because I start breathing with a snort as my airway opens up.

Is it a true apnea? I'm not sure. But it's the KIND of stopped-breathing event that made my wife badger me into going to get tested in the first place. Got so she'd sleep with her hand on my chest so if I stopped breathing she could shake me and get me going again.

Scary, huh?

[Swordz]

Dictionary.com definition for apnea:

"Temporary absence or cessation of breathing."

Its any absence of breathing, but its usually referred to as apneas associated with sleep. This association with sleep is because its negative effects are more prevalent with sleep, and therefore the common "knowledge" of apnea.

Amazing that OSA is relatively mainstream and getting the medical attention the disorder deserves. But what do I know; I'm just a kid spittin out words I don't understand.

[Snoredog]

Studying the different parts of the brain and OSA once upon a time I read that as we transition through the various stages of non-REM and REM sleep (thought to be REM sleep) that our brain turns "Off" parts of our physical muscle movement, mainly our limbs. It is thought it does this to protect us so we don't act out on our dreams and hurt ourselves during sleep (all sleep walking aside).

Also during this period of REM, non-essential muscles relax including the muscles in the throat and that of the tongue. If we are sleeping on our back gravity plays a part in the picture by allowing the tongue to fall into the back of the throat, when it does this it blocks off the airway and you have an apnea event.

CPAP works by pushing or stenting your tongue up and out of the airway. This is why when you sleep on your stomach or side you have fewer apnea events. It is also why those that have a UPPP surgery rarely find relief and/or actually get worse after the surgery, afterward they have a bigger hole for the tongue to land or fall into. This is also why some procedures like Pillar, LAUP and others simply don't work for OSA and those pushing those procedures are only doing so to take your money. They physically cannot prevent your tongue from falling into the back of the throat.

When you start to awaken, the brain turns back On those non-essential muscles and you wake up normally. By contrast, should the brain fail to turn those muscles back On, then you have a syndrome known as Sleep Paralysis, this is where you awaken and cannot move your arms or legs, you lay there wide awake and simply cannot move. For those that have it, it is a very scary situation especially if you don't know what is going on.

For those that experience this, simply knowing what is happening can help. If Patients experiencing this can simply fall back asleep again the next time they awaken they will awaken normally. Severe sleep deprivation and early stages of Narcolepsy are thought to be associated with this syndrome. If you have untreated OSA it is usually sleep deprivation as the cause.

Sleep paralysis info:
http://www.stanford.edu/~dement/paralysis.html

[Snoredog]

Ooops, sorry really didn't answer your question, but it's the opposite of what I said above

But to answer it, we don't experience apnea events because those involuntary muscles (that hold the tongue out of your throat) are ONLY turned OFF during REM sleep, or that is what they "think".

When you read "it is thought..." it means they kinda know what the brain is doing but not really cause the brain is so complex there is more they don't know about the brain than what they actually know. But it does make sense if you break it down.

[ozij]

and REM sleep (thought to be REM sleep)

Since REM stands for Rapid Eye Movement, and objectively observable and quatifiable measure, I wonder what you mean by "thought to be REM sleep". REM sleep is the stage of sleep where your eyes move rapidly from side to side.

It has a typical EEG, and is accompanied by

"REM Motor Atonia - The suppression, or paralysis, of voluntary muscles during REM sleep. These muscles become completely flaccid and limp."
(This, from http://www.sleepquest.com/s_sleeptopics_r.html, the site Stanford's evolved into - see http://www.stanford.edu/~dement/index.html )

Sleep walking, by the way, doesn't occur during normal REM sleep.


O.

[ehusen]

Well just to add a "me too" ancedotal statement...

I remember as a kid watching TV, that my mom would often yell at me to "take a breath". I wouldn't do it to the point of passing out and such, but it was obviously long enough to make those around me concerned. And I remember having to conciously focus on not holding my breath.

Doesn't mean anything in terms of my sleep apnea but it's interesting that I had this sort of "daytime symptom".